IMPALA EXPRESS CLINICAL LABORATORY SERVICE INC
NPI 1346530201
Clinical Medical Laboratory in Chicago, IL

Active since April 12, 2011CLIA 14D2018991 · Waiver
845 N MICHIGAN AVE STE 944E, 845 N. MICHIGAN AVE, SUITE # 944-E, CHICAGO, IL 60611(312) 202-0328(312) 202-0320 Get Directions Write a Review

NPPES record last updated: June 12, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Impala Express Clinical Laboratory Service Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMPALA EXPRESS CLINICAL LABORATORY SERVICE INC (NPI 1346530201) is a healthcare organization registered as a clinical medical laboratory in Chicago, Illinois and active in the NPI registry since April 2011. The organization holds a CLIA Waiver certificate valid through October 2, 2027 and lists Alemayehu M Gebresellassie, President, as its authorized official.

NPPES Registry Identity

NPI1346530201
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameIMPALA EXPRESS CLINICAL LABORATORY SERVICE INC
Location Address845 N MICHIGAN AVE STE 944E, 845 N. MICHIGAN AVE, SUITE # 944-EChicago, IL 60611-2213
Mailing Address845 N Michigan Ave Ste 944e, 845 N. Michigan Ave, Suite # 944-eChicago, IL 60611-2213 · (312) 202-0328 · Fax (312) 202-0320
Fax(312) 202-0320
Organization SubpartNo
Authorized OfficialAlemayehu M GebresellassiePresident · (847) 951-5168
Enumeration DateApril 12, 2011
Last NPPES UpdateJune 12, 2012
NPI 1346530201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in IL · 14D2018991
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
845 N MICHIGAN AVE STE 944E, Chicago, IL 60611

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2018991

Impala Express Clinical Laboratory, Inc · Chicago, IL
Active · expires Oct 2, 2027
CLIA Number14D2018991
Laboratory TypeIndependent
Certificate Effective DateOctober 3, 2025
Certificate Expiration DateOctober 2, 2027
Laboratory DirectorAlemayehu Gebresellassie
Laboratory Phone(708) 831-5107
Laboratory LocationImpala Express Clinical Laboratory, Inc4001 W Devon Ave - Ste 402, Chicago, IL 60646
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Technician, Pathology (Medical Laboratory)
845 N MICHIGAN AVE STE 944E
CHICAGO, IL 60611

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Impala Express Clinical Laboratory Service Inc's NPI number?

The NPI number for Impala Express Clinical Laboratory Service Inc is 1346530201. It was assigned to this organization in the NPPES registry on April 12, 2011.

Where is Impala Express Clinical Laboratory Service Inc located?

Impala Express Clinical Laboratory Service Inc is located at 845 N Michigan Ave Ste 944E 845 N. Michigan Ave, Suite # 944-E, Chicago, IL 60611. The listed phone number is (312) 202-0328.

What is Impala Express Clinical Laboratory Service Inc's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Impala Express Clinical Laboratory Service Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2018991) is associated with this NPI, valid through October 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Impala Express Clinical Laboratory Service Inc was last updated on June 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.